Am I bottoming out? (Photos)

Hi, I have my implants just over two years and although I've had this issue probably a year it doesn't cause me any pain or annoyance. It just feels slightly looser and what I would consider to feel more natural. Besides the fact I'm more conscious of the scar. I was just wondering is it dangerous? Although the photos are not great quality the scar is visiable.

Doctor Answers 4

Bottoming out

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You need better pictures to get good advice.  The quality of these pictures is too poor to really say for sure about the scar, but it doesn't look like there is any bottoming out.  Your best resource is the surgeon who performed her procedure and I would recommend you visit with him or her and voice your concerns for an in-person exam.Best of luck!

Dr. Subbio
Board-Certified Plastic Surgeon
Newtown Square/Philadelphia, PA

Philadelphia Plastic Surgeon
5.0 out of 5 stars 74 reviews

Am I bottoming out?

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Although I understand your concerns, I do not think that your photographs demonstrate "bottoming out". Always best to address your concerns directly with your plastic surgeon. Otherwise, enjoy the outcome of the procedure performed. Best wishes.

Signs of bottoming out

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It would be hard to tell if you are bottoming out without your before/after pictures and an in-person breast exam.

I would suggest you to follow-up with your board-certified plastic surgeon.

That being said, allow me to share information on clinical signs that arise when a patient is experiencing bottoming out.

Bottoming out is common when the inframammary fold is released and not firmly sealed and reinforced.

A weak inframammary fold will result in downward breast implant displacement once the breast implant slips below the natural or surgically lowered inframammary crease overtime.

Clinical signs:

  • Bottomed out implants end up too low on the chest wall with the inframammary scars travelling up onto the breast skin.
  • The nipples will not only point upward, but also be positioned higher on the breast mounds.
  • There will be no pain, but you may notice thinning of the skin at the bottom of the breast, which will allow you to more easily feel the breast implant.

It is good to be wearing supportive bras as this prevent further bottoming out. Supportive bras will apply upward pressure to the fold at the bottom of the breast.

To correct “bottomed out” breasts, a surgeon would need to secure the implant in an elevated position and then reinforce the implant capsule at the bottom of the breast with a suture technique. There may be a need for Acellular Dermal Matrix, a soft-tissue graft, in the repair. A smaller implant is often advisable, if the original was too large. In fact, receiving an implant larger than indicated by your breast characteristics and boundaries increases the risk of malposition. 

Please continue to have regular follow-ups with your surgeon to make sure your breasts are healing. Their recovery instructions should take precedence over all else you read here as they are better informed about your surgical details.

Hope this helps.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 518 reviews

Am I bottoming out?

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I do not see significant bottoming out. It is not dangerous. If you are comfortable with your implants do nothing.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.